Individual
JARED C FRATTINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1532 LONE OAK RD STE 235, PADUCAH, KY 42003-7946
(270) 442-9463
(270) 442-2241
Mailing address
1532 LONE OAK RD STE 235, PADUCAH, KY 42003-7946
(270) 442-9463
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
TP687
KY
208C00000X
Colon & Rectal Surgery Physician
TP687
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000222200
—
FL
01
—
42566
BLUE CROSS BLUE SHIELD
FL
Enumeration date
02/15/2008
Last updated
01/29/2025
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